The Minnesota Department of Education released the results from the survey Tuesday. Students in fifth, eighth, ninth and 11th grade participated in the anonymous survey administered every three years. Survey questions range from asking students about their emotional well-being to their overall feelings of safety at school.

The department of education received data from 85.5 percent of Minnesota school districts. The department previously offered the survey in 2013. From 2013-2016, officials reported an increase in long-term mental, behavioral or emotional problems for eighth, ninth, and 11th grade students.

“This year’s survey highlights the success of some recent public health actions focused on our youth,” Minnesota Health Commissioner Dr. Ed Ehlinger said in a statement. “It shows our actions to curb youth smoking and indoor tanning are reducing risky behaviors. However, it also identifies the growing threat of e-cigarettes and shows more must be done ensure all youth, regardless of race, sexual orientation or economic status, are getting a healthy start.”

Indoor tanning rates dropped significantly. Although, the department found that more than 2,000 11th grade female students had used a tanning bed in 2016.

Tobacco, alcohol and marijuana use also declined from 2013 and 17.1 percent of 11th grade students said they had used electronic cigarettes in the past 30 days from when the survey was taken. The department found the percentage of electronic cigarette use was twice as high for regular cigarette use.

“There are many factors outside of school that can prevent children from succeeding,” said Minnesota Education Commissioner Brenda Cassellius said in a statement. “That is why the Minnesota Student Survey is so valuable. Schools, districts, community organizations, local and state agencies rely on MSS data to identify the issues young people are facing, so that we can address those issues to strengthen student achievement.”